CPT 40530 Surgery - Digestive
Partial removal of lip Cost
Body System: Digestive
Medicare Facility Rate
$367
CMS PFS CY2026
Medicare Non-Facility Rate
$566
Office/clinic setting
Hospital Outpatient
$3
OPPS rate
Surgery Center (ASC)
$1
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
5.40
Work RVU
4.73
Facility PE RVU
0.86
Malpractice RVU
16.94
Total RVU
Frequently Asked Questions
How much does Partial removal of lip cost?
The Medicare facility rate is $367. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $3. Ambulatory surgery center rate: $1.
How much does Partial removal of lip cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $367.